Nicole Anne Lucibello

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

PTN0004329 Issued in CT

Practice address

10 Fairfield Blvd Unit C2
Wallingford, CT 06492-5903

Phone

(203) 969-4404

Fax

(203) 815-1661

NPI assigned

May 5, 2021

Last updated

May 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620172800000",
    "number": "1639752744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 CARLEN DR",
            "city": "NORTHFORD",
            "state": "CT",
            "postal_code": "064721607",
            "telephone_number": "203-889-7605",
            "fax_number": "203-815-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 FAIRFIELD BLVD UNIT C2",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064925903",
            "telephone_number": "203-969-4404",
            "fax_number": "203-815-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIBELLO",
        "first_name": "NICOLE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "",
            "desc": "Pharmacy Technician",
            "state": "CT",
            "license": "PTN0004329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy Technician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Pharmacy Technician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.